The Controversy Surrounding Chemical Abortion

Complications associated with abortions affect not only the embryo or fetus, which is terminated, but also its mother. As several studies have shown, they significantly increase the risk of suffering from mental disorders such as anxiety, depression, alcoholism or drug use.

A study recently published in the New England Journal of Medicine analyzes the efficacy and safety of medical abortion, using a combination of mifepristone and misoprostol.

Although it refers to chemical abortion as effective and safe, it also includes among its conclusions that “there is insufficient evidence on efficacy and safety at very early gestations before a pregnancy can be visualized with ultrasonography”.

It also concludes that medication abortion before confirmed intrauterine pregnancy was noninferior to standard, delayed treatment with respect to complete abortion.

The study included 1504 women from 26 backgrounds in nine countries and they were randomly assigned to either the early-start group (754 participants) or the standard group (750 participants).

In an intention-to-treat analysis, complete abortion occurred in 676 of 710 participants (95.2%) in the early-start group and in 656 of 688 (95.3%) in the standard group; the absolute difference between groups was -0.1 percentage points (95% confidence interval, -2.4 to 2.1).

Ectopic pregnancies occurred in 10 of 741 participants (1.3%) in the early-onset group and in 6 of 724 (0.8%) in the standard group, with one rupture before diagnosis (early-onset group).

Serious adverse events occurred in 12 of 737 participants (1.6%) in the early-start group and in 5 of 718 (0.7%) in the standard group (P = 0.10); most were uncomplicated hospitalizations for treatment of ectopic pregnancy or incomplete abortion.

Safety of the technique

The total number of abortions completed according to this study was 95%, meaning that five out of one hundred women were unable to complete the abortion and had to resort to other complementary abortion techniques.

As we have previously reported, the scientific evidence available on the risks of using the abortifacient mifepristone is objective and has been documented for some time.

When abortion is not consummated after the ingestion of RU-486, generally combined with misoprostol, the fetus is at high risk of serious deformities, according to some studies. They also show that its administration to pregnant women can trigger painful contractions, nausea, vomiting, diarrhea and heavy bleeding that persists even days after treatment, and often requires hospitalization.

Because of these complications, including some deaths, the FDA required RU-486 package inserts to warn of the risk of infection and bleeding from its use.

A study published in 2022 showed the results of a 17-year longitudinal analysis of 423,000 induced abortions and 121,283 emergency room visits within 30 days of the abortion between 1999 and 2015.

The publisher retracted it for unclear reasons, such as that the researchers collaborated with pro-life organizations.

One of the data shown in the study is that more than 60% of emergency room admissions related to the abortion pill were wrongly treated as spontaneous abortions in 2015. This data warns of the danger of hiding from the doctor that an abortion was induced by taking abortion pills.

Chemical abortion patients whose abortions are misclassified as miscarriages during an emergency department visit subsequently experience an average of 3.2 hospital admissions within 30 days.

According to this study, and in contrast to the data published now with a smaller sample, 86% of patients ultimately undergo surgical removal of retained products of conception (RPOC).

Chemical abortions are more likely than surgical abortions to result in a RPOC admission (OR 1.80, CL 1.38-2.35). Concealed chemical abortions are more likely to result in a subsequent RPOC admission than abortions without miscoding (OR 2.18, CL 1.65-2.88).

Miscoded/hidden surgical abortions are equally twice as likely to result in hospital admission as those without miscoding.

Bioethical assessment

It is incorrect in any case to speak of “safe abortion” to refer to both chemical and surgical abortion. The complications associated with the practice of abortion affect not only the embryo or fetus, which is terminated, but also its mother.

Women who have an abortion are at risk of suffering from mental disorders such as anxiety, depression, alcoholism or drug use, among others.

Women who have undergone an induced abortion have a 170% higher risk of mortality than women who have given birth to a live child. In addition, they have twice the risk of death in the year following the induced abortion compared to women who have suffered a spontaneous abortion.

Hiding this scientific evidence from women seeking abortion is denying them their right to choose freely, adequately weighing the negative consequences associated with abortion.

Abortion is an attack not only on the life of the unborn child, but also on the health of its mother. It is also not safe, given the available evidence on its associated risks.

Therefore, the claims in the recent article mentioned calling chemical abortion effective and safe hide a manipulation by those who defend abortion and ignore its consequences.